Think Fast

May is Stroke Awareness Month, and this serious condition is the third-leading cause of death in the U.S. Here’s what you need to know.

Q&A with H. Steven Block, St. Mary’s Hospital

Q: What is a stroke?
A stroke is a sudden vascular event that causes injury to the brain. Different strokes have different periods of evolution, but most occur suddenly. Some people may have symptoms that come and go quickly several times before a full stroke occurs.

There are a few types of strokes. Ischemic stroke is the most common type. It can occur from a closure of a blood vessel from a number of causes including a clot within the vessel as well as narrowing and ultimate closure of the vessel from atherosclerosis or inflammatory disorders of the blood vessel walls.

Hemorraghic strokes are bleeding in or around the brain. The biggest causes are bleeding in the brain from high blood pressure, or from an aneurysm, which is a bulge in a blood vessel wall that can rupture like a broken balloon. 

Q: What are common stroke symptoms?
Here are the major warning symptoms of a stroke. If any occur, [a person] should go to the emergency room immediately:
• An abrupt onset of numbness or weakness on one side of the body.
• Difficulty speaking or understanding what people are saying.
• Sudden visual loss in one or both eyes.
• Dizziness, impaired balance or difficulty walking.
• A severe, unexplained headache, especially if accompanied by a stiff neck. Think, “worst headache of my life.”

Q: What are the risk factors of strokes?
A: Some risks cannot be modified: age, gender, low birth weight and genetic factors.

There are plenty of modifiable risk factors that can reduce one’s chance of having a stroke. One of the biggest such factors is high blood pressure. Obesity (especially a large fat store around the midsection), poor diet, inactivity, smoking, diabetes, high cholesterol, carotid artery narrowing because of atherosclerosis,  significant coronary artery disease and sickle cell disease are all treatable risk factors.

Even if one doesn’t have any of the major risk factors, they shouldn’t falsely reassure themselves that their
symptoms are not from a stroke. Denial can be fatal—patients should still go to the ER immediately.

Q: What are the varied after-effects of a stroke?
The symptoms of stroke depend on the part of the brain that is affected. Some-times the larger the area of the brain that’s damaged, the greater the likelihood the stroke may be more severe. However, even small strokes in critical areas can produce significant disability.
If there’s a stroke in the left temporal lobe of the brain, the affected person may not be able to speak or understand language, or both. If there’s a stroke in the brainstem, one may see double, have paralysis, lose sensation in their face, stagger or have trouble

Some people are fortunate and experience a full recovery from stroke. 

Q: Why is it so important to seek medical attention immediately if you’re having a stroke?
It is critical to get to the ER as quickly as possible. Our best time to treat a stroke is within the first three hours. There are some interventions that can be quickly administered to save brain cells that are being starved of blood and oxygen and at risk of dying. Rapid intervention has the potential to greatly improve the outcome. Just remember, “time is brain!”

St. Mary’s Hospital is a certified stroke center. Of the 6,000 hospitals in the U.S., only 800 hospitals are certified as having a defined framework to rapidly evaluate and treat strokes, as well as meeting standards to minimize the possibility of complications that can occur following a stroke. This makes for better care and outcomes. [Editor’s note: UW Hospital is also a certified stroke center.]

Q: What’s the best way to prevent a stroke?
Prevention. There are some exciting treatments for stroke, but not every person may be a candidate. Even with treatment, some patients may still have significant disability after a stroke, so we need to work diligently on preventing strokes before they happen. This starts with teaching our children good exercise and eating habits. As adults we need to keep an ideal body weight, exercise, don’t smoke and treat conditions such as high cholesterol, high blood pressure and diabetes.

I would personally love it if we got so healthy, we could make a big impact in reducing stroke.

Shayna Miller is associate and style editor of Madison Magazine.

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